Traction Alopecia on Temples

I have been braiding my hair for many years. I want to stop & have my natural hair but I now only use the braids to cover my bald spots.The scalp is very soft to the touch. What can I do? can the hair grow back? are there any products I can purchase to help or will I need hair transplants? thank you

Doctor Answers (7)

Tight Hair Braiding Can Lead to Permanent Hair Loss (Traction Alopecia)

+2

Your alopecia (hair loss) may or may not be permanent.

Permanent hair loss is the result of permanently damaged hair follicles which may occur after years and years of braiding your hair.  The tight pulling may lead to repeated trauma to the follicle and ultimately killing the follicle and permanent hair loss.  Once the trauma from braiding is stopped, then there shouldn't be anymore hair loss (however it would be unusual to regain any of the lost hair).

There are two things you can and should do right now:

1) I agree with the other answers here – you (or anyone) who suspects this type of hair damage from braiding, especially the kind that results in a tight braid, should immediately stop. 

2) See a hair loss specialist as soon as possible to assess the damage and decide on the best course of action.  If the hair follicles are not damaged, then topical minoxidil may help. If the follicles are permanently damaged, then surgical hair restoration may be your only option.  Modern surgical hair transplant techniques, however, create excellent natural looking results, so don’t despair if in fact you’ve accidentally, permanently damaged your hair.

 


New York Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Hair Loss Caused by Traction Alopecia

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Hair loss due to severe traction alopecia may respond to medical treatment (such as Steroids, minoxidil) , while advanced cases that have resulted in scarring alopecia would not respond to medical treatment.  If you notice the peripheral thinning early on, the hair may have a chance to grow back. I advise that you first stop braiding your hair. Traction alopecia can worsen, and hair loss can spread from the temples to the entire anterior and posterior hairline. Next, I advise you to consult a dermatologist for a closer look. If the trauma from your traction alopecia is severe, you will need a hair transplant.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.5 out of 5 stars 15 reviews

Traction Alopecia Can Lead to Scarring

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I would first recommend discontinuing the brading-- I still still a number of hair follicle units in your photo (though difficult from that one photo to assess) and you may find many of the hairs grow back with sufficient time without braiding.  Unfortunately, scarring may have occurred, which is quite common with traction alopecia.  In this case, a  surgical treatment, such as hair transplant, would be necessary.  No topical agents will cause regrowth in an area of scarring hair loss.

Jeffrey C. Poole, MD
Metairie Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

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Traction Alopecia - Hair Transplantation

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For women with traction alopecia from tight braids the first step is to remove the braids. Minonoxidil can soemtimes help promote hair growth in follicles that were injured (but not permanently damaged)

In many individuals with long lasting hair loss, the only definitive means to improve hair is with a hair transplant. Be sure to have a thorough scalp examination to ensure you don't have any other hair loss conditions which would reduce the chances of success of a hair transplant.

Jeff Donovan, MD, PhD
Toronto Dermatologist

Hair loss due to traction

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Hair loss associated with tight weaves and braiding is known as traction alopecia.  This is very common and is easily treatable with hair  transplantation surgery.  Depending on the area of hair loss, grafts can be placed that will appear natural and undetectable.  The donor site scar also heals remarkably well.  Most onlookers will never know that you had this procedure.  I have been impressed with our treatments using micorgrafting techniques. 

Allan J. Parungao, MD
Oak Brook Plastic Surgeon
4.5 out of 5 stars 12 reviews

Traction alopecia and hairstyling practices

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Traction alopecia is sadly very common amongst Black patients of all descents, as well as any persons who exact a lot of tension on the hair, such as ballerinas who pull their hair in a tight bun.  Unfortunately, it is poorly recognized, and we must do more to educate each other about the problem.  If caught very early, before follicles are scarred, a degree of hair growth may be achieved.  If the follicles have scarred over, it will not be possible to regain the hair growth in these areas.  This can be determined by your dermatologist.

As far as treatment options, just as Dr. Rogers suggested, we often recommend minoxidil and do scalp injections of Kenalog to reduce inflammation and stimulate hair growth.  Sometimes scalp massage may increase blood flow to the area and help somewhat.

Traction, and most types of alopecia, are not only dependent upon taking care of the root, but also maintaining the hair shaft as well.  Moisturizing shampoos, regular conditioner and hot-oil treatments are definitely a plus.  Some may take hair vitamins, such as biotin, to stimulate hair growth.  Decreasing to eliminating the major stressors on the hair is also key.  I would avoid braids, weaves, tight buns, and other stressful styles, and I often discuss with patients hairstyles that they can use to minimize hair damage.  Too frequent and strong chemical relaxers may also be a problem, and discussing transitioning to natural hair (which may or may not include texturizing as a bridge) may be in your future.  This can be done in a way that optimizes your sense of style and minimizes stress on the hair follicle and shaft.

I would definitely talk this over with your dermatologist, sooner rather than later, because all too often patients approach us after much damage has been done.  There are also other types of alopecia to be considered alongside traction, so an evaluation is necessary.  Best of luck.

Dornechia George Carter, MD
Dallas Dermatologist

Traction alopecia can be treated

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Traction alopecia is a real problem for many African American women. It results from prolonged tension on the follicle, and can be worse in patients who have used relaxers for many years. You can start by seeing a dermatogist for injections of anti-inflammatory medicine (Kenalog) in the affected areas. Also topical minoxidil can help. Give these methods 6-12 months and if you are still not happy consider hair transplatation. And in the meantime steer clear of damaging relaxers and tight braids!!

Nicole E. Rogers, MD
New Orleans Dermatologist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.